I

104TH CONGRESS

1ST SESSION H. R. 224

To eliminate fraud in the payment of supplemental security income benefits

to children by reason of disability.

IN THE HOUSE OF REPRESENTATIVES

JANUARY 4, 1995

Mr. DICKEY (for himself and Mr. SHAYS) introduced the following bill; which

was referred to the Committee on Ways and Means

A BILL

To eliminate fraud in the payment of supplemental security

income benefits to children by reason of disability.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. REPLACEMENT OF CASH BENEFIT WITH MEDI4 CAL VOUCHER.

5 (a) IN GENERAL.—Section 1611(b) of the Social Se6 curity Act (42 U.S.C. 1382(b)) is amended by adding at

7 the end the following:

8 ‘‘(3) Notwithstanding paragraphs (1) and (2), the

9 benefit under this title for a child who has not attained
2

•HR 224 IH

1 18 years of age shall be vouchers issued pursuant to sub2 section (j).’’.

3 (b) ISSUANCE OF VOUCHERS FOR TREATMENT OF

4 DISABLING CONDITIONS OF CHILDREN ELIGIBLE FOR

5 SSI BENEFITS.—Section 1611 of such Act (42 U.S.C.

6 1382(b)) is amended by adding at the end the following:

7 ‘‘(j)(1) The Commissioner shall issue to each child

8 eligible for benefits under this title who has not attained

9 18 years of age vouchers which may be used to cover the

10 cost associated with treating the blindness or disability of

11 the child.

12 ‘‘(2) The Commissioner shall, by regulation—

13 ‘‘(A) develop an appropriate measure of the an14 ticipated costs associated with treating each kind of

15 blindness or disability from which a child may suf16 fer, which shall take account of the severity of the

17 blindness or disability, any geographic variation in

18 such costs, and such other factors as the Commis19 sioner deems appropriate; and

20 ‘‘(B) establish a schedule which shall be used to

21 determine the dollar value of the vouchers to be is22 sued to a child to cover the costs associated with

23 treating the blindness or disability of the child.

24 ‘‘(3) The Commissioner shall pay to each provider of

25 health care goods or services that is licensed by a State,
3

•HR 224 IH

1 or by a professional health care organization approved by

2 the Commissioner, that submits to the Commissioner a

3 voucher issued under this subsection an amount equal to

4 the face dollar amount of the voucher.’’.

5 SEC. 2. FRAUD CONTROL.

6 Part B of title XVI of the Social Security Act (42

7 U.S.C. 1383–1383d) is amended by adding at the end the

8 following:

9 ‘‘SEC. 1636. FRAUD CONTROL.

10 ‘‘(a) NOTICE OF COOPERATION.—The Commissioner

11 shall notify the Inspector General of the Department of

12 Health and Human Services and each State agency re13 sponsible for the detection of fraud in cases involving ben14 efits under this title, in writing, that the Commissioner

15 is willing to assist in the detection of such fraud and that

16 the Commissioner requests the name and social security

17 account number of each person who is suspected of such

18 fraud.

19 ‘‘(b) INVESTIGATION OF SUSPECTED FRAUD.—With20 in 30 days after the Commissioner receives a name sub21 mitted pursuant to the written request required by sub22 section (a), the Commissioner shall conduct such activities

23 as the Commissioner deems appropriate, including benefit

24 redetermination, to ascertain whether the person named

25 is eligible for benefits under this title.
4

•HR 224 IH

1 ‘‘(c) DEVELOPMENT OF PROFILES; PERIODIC TAR2 GETED REDETERMINATIONS.—The Commissioner shall

3 develop profiles of the kinds of cases that have a high

4 probability of fraud, and shall conduct periodic targeted

5 redeterminations based on such profiles.’’.

Æ